Bon Secours Community Hospital has opened a temporary emergency department as it advances its $40 million project to create a medical village where patients can access health and social services in one place.

On Wednesday Cardinal Timothy Dolan dedicated and blessed the temporary department at the hospital in Port Jervis in Rockland County, which is part of the Westchester Medical Center Health Network but maintains its Catholic identity.

The 2,500-square-foot temporary ED will have 10 private bays as well as a cardiac treatment area, triage space and diagnostic equipment.

The hospital hopes to open a larger, permanent, 10,000-square-foot emergency department with five observation beds in February.

The project, which will allow the current 8,000-square-foot emergency department to be demolished, is one phase of Bon Secours' creation of a medical village in collaboration with the Orange County Department of Mental Health Services and Cornerstone Family Healthcare. The hospital will offer medical care, behavioral health services, social programs, wellness activities and exercise classes in one place.

"We're trying to concentrate more on the wellness and prevention part of it and to be that anchor in the community," Leahy said. "We're trying to have all the resources people find in the community instead of having them more fragmented in different areas."

As part of its shift toward outpatient care, the hospital will decertify about 30 of its 122 licensed beds. The number of staffed beds, 92, will remain the same. The hospital has about 75 patients on an average day, Leahy said.

The hospital has already started on renovations to convert an empty unit into private patient rooms, which will be the standard throughout the hospital. Hospitals around the metro area have gravitated toward single-bed rooms for their benefits in improving patient satisfaction and their potential to control infections.

The project is funded in part through a $24.5 million capital grant the state awarded the hospital in 2016 to create a medical village. It first broke ground on the project in April 2018, and Leahy said she expects it to be complete in 2021.

It is one of two medical villages being designed within WMCHealth. HealthAlliance Hospital in Kingston is transforming its Broadway campus into a medical village and expanding its Mary's Avenue hospital through a $133.6 million project. —Jonthan LaMantia

Hospice organization responds to federal report on Medicare billing

The National Hospice and Palliative Care Organization on Wednesday issued a response to an Office of the Inspector General report, "Medicare Part D Is Still Paying Millions for Drugs Already Paid for Under the Part A Hospice Benefit."

The report found that Medicare Part D paid for drugs in 2016 that hospices should have paid for under the Medicare Part A hospice benefit. The OIG estimated that, based on its sample results, Medicare Part D paid $160.8 million for drugs that hospices should have covered.

In response, the National Hospice and Palliative Care Organization noted that part of the Medicare Part A hospice benefit includes coverage for drugs related to terminal illness and that Medicare's policies are intended to prevent Part D from paying for drugs that should be covered by hospices.

"NHPCO agrees that hospice providers should be held responsible for drugs that are related to the terminal diagnosis and related conditions," the organization said. "There may be instances where a drug is no longer effective, but the patient may still choose to continue and pay privately for it. There may be instances where the drug is not related to the terminal illness and related conditions and should be billed separately to Medicare Part D."

Overall, "The OIG report represents an opportunity to revisit Medicare Part D policy and further clarify billing and payment practices that will promote transparency and ensure that hospice patients receive the medications they need every day," the organization said.

In July the organization and local members applauded a group of U.S. senators who launched a bipartisan caucus focused on improving access to palliative care. At the time, Edo Banach, president and CEO of the organization, said the organization looked forward to working with the caucus to focus on structural reform of the Medicare hospice benefit, among other initiatives.

For its part, the OIG recommended that the Centers for Medicare and Medicaid Services work directly with hospices to make sure they are providing drugs covered under the hospice benefit as well as develop a strategy to make sure that Medicare Part D does not pay for drugs that should be covered by the hospice benefit. —Jennifer Henderson

Plaintiffs in discrimination case say Mount Sinai hasn't done enough

The current and former employees at Mount Sinai's medical school who are suing the organization for sex, age and race discrimination said the school's signing on to Time's Up Healthcare is a "smokescreen" to hide a discriminatory environment.

The eight plaintiffs allege that Mount Sinai and several medical school leaders created a hostile work environment that undermined the work of women in their 40s and older. Although they applauded Mount Sinai's joining of Time's Up Healthcare, they said the medical school's dismissal of their claims conflicts with that organization's mission.

Time's Up Healthcare, part of the broader Time's Up movement, formed this year to combat sexual assault, harassment and discrimination in health care workplaces. Organizations are invited to sign on to address these iniquities, and the Icahn School of Medicine at Mount Sinai did so this week. Students and staff earlier this year had called on the medical school to join the movement in online petitions that received hundreds of signatures.

Dr. Carol Horowitz, Icahn's dean for gender equity in science and medicine, called joining Time's Up Healthcare "a reflection of our ongoing commitment to ensure that this generation of medical leaders—and the next—experience fairness and equity in science and medicine."

The plaintiffs saw it differently.

"It is distressing that, rather than use this case as an opportunity to acknowledge a significant problem and make serious attempts to address it, Mount Sinai leadership is choosing to dig in its heels in denial and self-protection," they wrote in a statement.

They said that to live up to its signing on to Time's Up Healthcare, Mount Sinai should "acknowledge and correct past harms." —J.L.

Brain blood flow tied to Parkinson's risk

Medical conditions and habits that affect blood flow in the brain are associated with a diagnosis of Parkinson's disease, a progressive nervous system disorder, according to a study from Weill Cornell Medicine and New York-Presbyterian investigators published today in the Annals of Neurology.

Among the more than 1 million Medicare beneficiaries followed for an average of 5.2 years, about 15,500, or 1.5%, were diagnosed with Parkinson's disease. Most cerebrovascular risk factors evaluated were associated with a Parkinson's diagnosis.

Investigators believe the study is important to determining whether better management of factors including having had a stroke, hypertension or diabetes and using tobacco may help prevent Parkinson's.

"While much of the public is already aware that cerebrovascular risk factors increase the odds of developing Alzheimer's disease, people don't know that these same factors could put them at a risk for Parkinson's," said Dr. Babak Navi, senior study author and neurologist at Weill Cornell Medicine and New York-Presbyterian, in a statement. "I think new knowledge about this association is empowering because it gives doctors and their patients another reason to get cerebrovascular risk factors under control."

The Parkinson's Foundation estimates that close to 1 million people in the U.S. will be living with Parkinson's disease by next year. It places the direct and indirect costs of the disease at $52 billion a year, with medications costing an average of $2,500 a year and therapeutic surgery costing as much as $100,000 per patient. —J.H.

AT A GLANCE

WHO'S NEWS: Dr. Andrew Schiff has succeeded John Rafferty as the board chair at the Visiting Nurse Service of New York. Schiff is a longtime VNSNY board member. He is also the great-great-grandson of Jacob Schiff, a close friend and main early benefactor of the organization's founder, Lillian Wald.

ABORTION DISPUTE: The U.S. Department of Health and Human Services’ Office for Civil Rights said the University of Vermont Medical Center violated federal law by requiring a nurse to participate in an elective abortion, Modern Healthcare reported. A former employee had allegedly been scheduled to participate in the procedure despite voicing her religious or moral objection. The hospital denied the allegations.

AUTISM: A Manhattan tech startup has thrived with a workforce in which a majority of employees are on the autism spectrum.

HEALTH SEARCHES: Pinterest said on Wednesday that searches related to vaccines, such as "measles" and "vaccine safety," will only return results from public health organizations, CNN reported. "We're taking this approach because we believe that showing vaccine misinformation alongside resources from public health experts isn't responsible," said Ifeoma Ozoma, public policy and social impact manager at Pinterest, in a statement.

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